Top Topics
Indeed it does. Accessible via a menu. Overall the AirSense10 is a good machine, if a little pricey.
Weight loss is the only known potential cure for obstructive sleep apnoea (not central). It doesn't work for everyone because OSA can be caused by a complex web of factors, but it can work for many. So, it is possible that your sleep lab has cured your OSA. However, you said that were on BiPAP, and this is only used in cases where obstruction is not the only problem. CPAP holds you airway open preventing obstruction whereas BiPAP actually breathes in and out with you, augmenting your respiratory effort (as well as holding your airway open). It is used for treating central sleep apnoea and various forms of respiratory failure. How well do you know the diagnosis which lead to you using BiPAP? I am not a doctor (I am a sleep tech with 16 years experience), but would suggest that you do some investigation to find out exactly what is going on. Keep asking until the answers start to make sense. There are too many people in the medical industry who can't be bothered to take the time to engage in proper education of patients.
You say that you gained confidence in "messing" with some of the settings. Exactly what changes did you make? There are some forums which support, and even recommend, potentially dangerous practices in modification of CPAP settings. I'm sure don't want your health to be at risk as a result of some dodgy advice. I'm not a doctor but I have 16 years experience in the field as a technician and am happy to give you the benefit of my knowledge.
Having blocked sinuses can make things more annoying certainly, but ultimately if that were the only problem it would eliminated as soon as you opened your mouth. Obstructive sleep apnoea (as opposed to central) is an obstruction at the back of the throat, so conditions involving your sinuses and nose are a separate problem. They can certainly interact to complicate the situation, but they are not the cause. Your nose and sinuses can also be irritated by the air from PAP treatment, which is where mask selection and humidification become important.
You could simply turn your humidifier down a little bit. That would be the simplest solution. Another trick is to wrap the tube in a scarf or similar to insulate it. Heated tubing would probably be very useful in this situation but it is a bit pricey. Could you possibly just put the machine downhill of you so that the water drains back into the humidifier.
The heated tube is probably worth a shot. It makes the humidifier more efficient by preventing rain out (condensation due the air cooling as it passes along the tube from the machine to the mask). A quick browse online tells me that it is expensive. If your supplier wants more than $70 I'd think about getting it online as I saw prices for around $50 - $70. Just make sure it's the ClimateLineAir for the AirSense 10 (stuipid ResMed capitalisation), beyond that you just plug it in. Bear in mind that at 70 years of age, 5.5 hours/night after only just 4 months is pretty good. A whole night would obviously be better, but that will still significantly benefit her health. Also, check for mask leaks as they tend to reduce the effectiveness of humidification.
SleepMommy703, the air always flows from your nose through your mouth as the 2 are joined and the join doesn't close (barring horrible injury), so I doubt that is the cause of your woes. You mentioned that when you turn up you get noisy condensation, which in the business we call rain out. Do you have a heated tube? If so, try turning up the tube heating level also. Also, you can try tucking the hose under the covers with you to keep it warm and thus prevent rain out. Another good trick is to wrap it in a scarf for insulation. You can buy CPAP tubing insulators, but they work no better than a scarf and are expensive, so I wouldn't bother. Have you considered trying a full face mask to see if this reduced your dry mouth? If you don't like the bulk of them, the Amara View works very well for most people and is much smaller the average full face mask.
Central sleep apnoea is almost never treatable with CPAP. This is because all CPAP does is open you airways up. This is effective in treating OBSTRUCTIVE sleep apnoea as the problem in that case is an obstruction caused by airway collapse. However, Central sleep apnoea involves malfunction of the breathing muscles such that they stop pushing air in and out for short periods. The reason that CPAP almost never works for Central sleep apnoea is that it doesn't matter how much your airway is opened up if them muscles aren't pushing the air in and out. I say "almost never" because I have seen instances of what appears to be central apnoea being corrected by CPAP, but they are rare. In most cases bi-livel ventilation, or Bi-PAP, of some sort is required. The difference is that a BiPAP breathes in and out with the patient, moving up and down between 2 pressures. It also monitors the time between breaths and can add in some breaths if the patient doesn't breathe themselves within a given time. BiPAP is also used for people who don't have gaps in their breathing but just don't push enough air in and out so their oxygen drops and, in some cases, their CO2 rises (respiratory failure). Since BiPAP augments your natural respiratory effort and helps you push more air in and out, it can be very effective in treating this condition. The machines look identical apart from the name on them. It is worth knowing the difference so that you can understand your treatment and make sure it is appropriate. If your doctor (and it should be a doctor) recommends BiPAP (or VPAP or bi-level) treatment then it means you have something other than just simple OSA. Either that or they are looking to make some money because a BiPAP usually costs $AU 5000 - $AU 8000 (you'll have to do the conversion). ASV (Auto Servo Ventilation) is a subset of BiPAP that was invented specifically to treat Cheyne-Stokes breathing (a specific from of central sleep apnoea) in the setting of low CO2. It is NOT effective in helping improve ventilation for people who's muscles are weak. Having said this, may people in the medical field (including doctors) don't really understand ASV, see the "Auto" part of the name, assume they can prescribe it to anyone with central events and it will magically fix them. This is often not the case. Setting any bi-level device properly is a complicated process and should always be done in the setting of a formal, in-lab sleep study conducted by an experienced technician. Sorry to bang on a bit, but I hope this clarifies the whole situation a bit. If you have questions, feel free to ask.
Probably the biggest barrier to compliance is education. I see so many patients who don't really understand what OSA is, why they're having a sleep study or why they should use CPAP. This tends to greatly reduce compliance.
Another is suppliers of various kinds who don't take the time to follow up their patients appropriately. Getting the right setup can make the world of difference, but this can only be achieved through consultation and patience. However, more money can be made by flinging a CPAP at someone and shoving them out the door.
A properly conducted sleep study should reveal if you have OSA and if CPAP is of benefit. A good doctor should be able to clearly explain all of this. Beyond that, the exact choice of mask and a few other variable can have a big impact. What data is your NP basing your new pressure on? Is she just making it up? There's a good reason why this should be done by a trained technician while you are sleeping at a lab - so you can be sure it works.
Be cautious about surgeries. There are surgeries to realign the jaw used in treating OSA but they are pretty hideous and generally don't work.
